Individual
IKHLAS GANGRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1629 OLD GLORY RD, LINCOLN, NE 68521-1554
(402) 817-4959
Mailing address
220 OAKCREEK DR # NE68528, LINCOLN, NE 68528-1587
(402) 817-4959
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
02/27/2025
Last updated
02/27/2025
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